NPI 1104220201 · live from the CMS NPI Registry
Kayla Diana Broksle, B.S.
Behavior Analyst in Omaha, NE. National Provider Identifier 1104220201, active.
NPI record
| NPI | 1104220201 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 444 S 44th St, Omaha, NE 68131 |
| Practice phone | 402-559-8863 |
| Mailing address | 985450 Nebraska Medical Ctr, Omaha, NE 68198 |
| Enumerated | October 17, 2014 |
| Last updated | October 17, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.